Ethical Problems
Among many historical cases that have contributed to the approach we use with patients today, The Willowbrook Hepatitis Case stands out above the rest. The contribution of this study is what ultimately lead to the establishment of the Belmont Report and the Institutional Review Board. Both were formed in protection of human participants in research. Willowbrook State School in Staten Island, N.Y. was the home of mentally disabled children back in 1955. Throughout the course of the next 15 years, the conduction of an unethical Hepatitis experiment was implemented, putting the children and staff at risk. According to Doctor Saul Krugman, prior to the start of the study, the natural infection of Hepatitis had become a prominent issue at Willowbrook, resulting in 30-50% of all stuff and child testing positive for Hepatitis (Goldby, 1971). Although a relatively mild disease that affects the liver, symptoms also include jaundice, fatigue, abdominal pain, nausea, loss of appetite, diarrhea, and fever. Hepatitis is typically spread when an object (toy, finger, ect.) that is contaminated with the feces of the infected person, is put in another persons mouth (Rothman, 2009). Over the course of the 15 years of experiments, there were more than 700 children involved in the study. Of these 700 children, they were put into two different categories—the experimental group was injected with the protective antibody, Gamma Globulin, which was a taken from the blood of those already infected. The other group was not deliberately infected, however they were surrounded by those that were. If the control group did indeed develop Hepatitis, it was from natural causes. The researchers were then able to observe the different immunities to the disease (Rothman, 2009). Through the development of the studies, researchers observed that two different viruses caused the differing symptoms. Researchers were able to conclude that there were two strains of hepatitis, A & B. They learned that Hep B was more difficult to contract since it is spread through blood and sexual contact. They also learned that Hep B is a more chronic infection, where as Hep A is more surmountable. Although researchers were able to justify that many children would become naturally infected with Hepatitis during their stay at Willowbrook, this study is an example of blatant unethical practice (Rothman, 2009). At the time, researchers believed that the benefits outweighed the potential harms. They said that they chose to conduct the study at Willowbrook since there was already an abundance of Hepatitis cases there already, not because the children were mentally disabled. On the contrary, the study provided an incentive to those patients who chose to take part in the study. In an otherwise crowded and unsanitary residence, students were given a much more desirable room in the newer part of the facility (Masden, 2013). Although parents were given a consent form, they were not fully informed of the risks within the study. It is the duty of a health care professional to always be working for the betterment of the patients as well as the staff and facility. It is deliberately unethical to use facilities failings into an experimental advantage. The patient’s rights and best interests supersede any consideration for what may or may not benefit humanity (Rothman, 2009). Among other unethical boundaries that were crossed: Mentally disabled children don’t fully understand the risks of the study they are participating in. The method in which children were recruited for the study was questionable. Parents inquiring about the residents were told there were not any openings in the home unless they were able to participate in the study. Parents who sought out care and help for their child did not seem to have any other options. Doctors said there was already an abundance of cases within Willowbrook, however this was due to the over crowding and unsanitary conditions. They were capable of improving this but chose to take advantage of the situation for the well being of the study (Rothman, 2009). There was a blantant disregard for children with mental disablities. Infecting any human being with a potentially harmful disease for the reaserch of human wellness is unethical and discriminatory. Although, in retrospect, this was the begining of what we now have perfected as the vaccine.